Development of the Activity Effort Scale for women aging with paralytic polio

Mixed-Methods Study of Disability Self-Management in Mexican Americans With Osteoarthritis

BACKGROUND

Health disparities in osteoarthritis (OA) outcomes exist both in the occurrence and treatment of functional limitation and disability for Mexican Americans. Although the effect of self-management of chronic illness is well established, studies demonstrate little attention to self-management of function or disability, despite the strong potential effect on both and, consequently, on patients' lives.

OBJECTIVE

The purpose of this study pilot was to develop and test key variable relationships for a measure of disability self-management among Mexican Americans.

METHODS

In this sequential, two-phased, mixed-methods, biobehavioral pilot study of Mexican American women and men with OA, a culturally tailored measure of disability self-management was created, and initial relationships among key variables were explored.

RESULTS

First, a qualitative study of 19 adults of Mexican American descent born in Texas (United States) or Mexico was conducted. The Mexican American Disability Self-Management Scale was created using a descriptive content analysis of interview data. The scale was tested and refined, resulting in 18 items and a descriptive frequency of therapeutic management efforts. Second, correlations between study variables were estimated: Disability and function were negatively correlated. Disability correlated positively with social support and activity effort. Disability correlated negatively with disability self-management, pain, and C-reactive protein. Function was positively correlated with age, pain, and depression. Liver enzymes (alanine transaminase) correlated positively with pain and anxiety.

DISCUSSION

This mixed-methods study indicates directions for further testing and interventions for disability outcomes among Mexican Americans.

Sex/gender disparities in health outcomes of individuals with long-term disabling conditions

BACKGROUND

Women with disabling conditions experience health disparities relative to nondisabled women, but few studies have compared women and men with disabling conditions.

OBJECTIVES

To investigate gender differences in physical functioning and emotional health among individuals with long-term disabling conditions, that is, neuromuscular disease, multiple sclerosis, postpolio syndrome, or spinal cord injury.

METHOD

From a mailed survey of 1,862 adults with long-term disabling conditions, we used the 12-item Patient-Reported Outcomes Measurement Information System (PROMIS) physical functioning to assess physical limitations in activities and Patient Health Questionnaire-9 (PHQ-9) for emotional health and severity of secondary conditions (rated 0-10). Least square means models were used to estimate marginal mean PHQ-9 scores and severity of secondary conditions by age and sex adjusted for diagnosis. Generalized linear models were performed to determine the association between sex/gender and PROMIS physical function t score, controlling for age and diagnostic group with potential Age × Sex interaction.

RESULTS

Women reported more fatigue than men (5.48 ± .08 vs. 5.13 ± .11, p = .01) and more pain (3.99 ± .08 vs. 3.67 ± .11, p = .03). Women aged 45-54 had higher average PHQ-9 scores than men aged 45-54 (M = 8.05, SE = .33 vs. M = 6.35, SE = .42, p < .007) adjusted for diagnosis. Younger women had higher physical functioning than younger men while older women had lower physical functioning than older men adjusted for diagnostic group (p = .0003 for the interaction term).

CONCLUSION

Middle-aged and older women with long-term disabling conditions experience considerable health disparities in physical functioning and emotional health compared with middle-aged and older men with similar conditions. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Factors associated with disability among middle-aged and older African American women with osteoarthritis

BACKGROUND

Middle-aged and older African American women experience disproportionate rates of functional limitations and disability from osteoarthritis (OA) compared to other racial ethnic groups; however, little is known about what factors contribute to this disparity within African American women.

OBJECTIVE

To examine factors associated with physical function and disability among African American women ages 50-80 with OA using the disablement process model.

METHODS

This descriptive study included 120 African American women with OA from the Southwestern region of the United States. Regression techniques were used to model the correlates of physical function and disability and to test a mediation model.

RESULTS

BMI and pain severity were significantly related to functional limitations. Depressive symptoms mediated the relationship between racial discrimination and disability.

CONCLUSION

Biological, intra-individual, and extra-individual factors are related to disablement outcomes in this sample of African American women, which is consistent with theory suggesting the need for treatment coupled with environmental modifications. This study can inform the development of future bio-behavioral interventions.